Antibiotics and Children: Where do we draw the line?

1. Antibiotics and Children: Where do we draw the line? Presented by: AlexaDiGaetano, RusselTurco, Erica Bliszcz, Chelsey Kiefer, Alyssa Bartels, Kara Nesbitt

2. Background • Antibiotics: one of the scientific breakthroughs of the 20th century • Early 1900’s: no medicines against common germs • Before antibiotics, 90% of children with bacterial meningitis died • Strep throat considered a fatal disease • Other serious infections caused by aggressive bacteria reproduced with extraordinary speed and led to serious illness/death

3. Background • First antibiotic: Penicillin • From nearly the start, doctors noticed Penicillin was not useful against certain strains of Staphylococcus aureus (bacteria that causes skin infections). • As of 2009, most popular for kids: Amoxicillin

4. Issues • Children take too many antibiotics due to doctors overprescribing them, even when antibiotics may not cure the illness. • Parents do not know the difference between viruses and bacterial infections. • Antibiotic resistance continues to increase.

5. Primary Research Pharmacy Database Audit • 200,000 prescriptions Results • 40,000 or 20% of prescriptions given to children with viral illness

6. Primary Research • Experiment • 1,556 Parents: Group A (control) 886 parents Group B (experimental) 886 parents • Experiment Results • Group A: No parents asked about antibiotics • Group B: 81% of parents asked doctors about reasoning for antibiotics and other organic remedies.

7. Secondary Research • Survey of American pediatricians: • 40%- parents requested antibiotics • 30%- physicians complied knowing they weren’t needed • Overuse of antibiotics links to antimicrobial resistance • 21%- pediatric ambulatory visits result in antibiotic prescription • 70%- antibiotic prescribed was unnecessary • 23%- unnecessary antibiotic prescriptions for respiratory visits • Concerns of “superbugs” emerging

8. Secondary Research • Studies show parents provided with information prior to children becoming ill resulted in a • 16% decrease of consultations for sore throat • 13% for cough • 40% consultation decrease per person/year • Interventions prove more effective when given to parents and children • Written information with focused content remains more effective than generic messages

9. Secondary Research Report Audit by Pediatrics • 1993-2008 • 24% drop in antibiotics for respiratory infections • 19% drop in antibiotics for colds • Overall, 58% children prescribed antibiotics actually had a respiratory infection • 2011 • Greater than 50% of all prescriptions written for children 14 and under deemed unnecessary • Parents of infants demand antibiotics-difficult for doctors to refuse

10. Audiences

11. Audience Ranking Chart

12. MAC Triad

13. Issue: Children take too many antibiotics due to doctors overprescribing them, even when antibiotics may not cure the illness. • Objective 1.0 Reduce the number of antibiotics prescribed to children in the U.S. by 10% in one year. • Strategy 1.1 Refresh doctor knowledge on differences between viruses and bacterial infections to reduce the number of prescriptions written. • Tactic 1.1.1 Trade show with speaker • Tactic 1.2.1 Newsletters • Tactic 1.3.1 Direct Mail • -Letter describing health concern • -Insert

14. Issue: Parents do not know the difference between viruses and bacterial infections. • Objective 2.0 Increase parents’ understanding of viruses versus bacterial infections by 25% within three months. • Strategy 2.1 Provide parents with educational material to reduce the number of doctor visits that lead to prescriptions for antibiotics. • Tactic 2.1.1 Create and launch an informational web campaign. • Tactic 2.1.2 Medical brochure explaining differences between viruses and bacterial infections • Tactic 2.1.3 Question and answer sessions with medical expert

15. Issue: Antibiotic resistance continues to increase. • Objective 3.0 Increase media awareness by publishing articles in one out of ten outlets that receive information. • Strategy 3.1 Highlight health risks of children taking too many antibiotics to increase interest of parents. • Tactic 3.1.1 Editor lunch-ins • Tactic 3.1.2 News releases • Tactic 3.1.3 Commercials

16. Budget

17. Evaluation • Objective 1.0 Reduce the number of antibiotics prescribed to children in the U.S. by 10% in one year. – MET • Refreshed doctors’ knowledge • Increased attendance • 20% of doctors attended

18. Evaluation • Objective 2.0 Increase parents’ understanding of viruses versus bacterial infections by 25% within three months. – MET • Provide parents with educational information • Web campaign • Successful; reached a total of 50% of our target audience • Brochure with difference between viral and bacterial infections • 60% of parents questioned the need for antibiotics • Q&A session • Health professionals answered all questions parents had

19. Evaluation • Objective 3.0 Increase media awareness by publishing articles in one out of ten outlets that receive information. – MET • Highlight antibiotic resistance in children. • Editor luncheons • Total of 50 editors attended • News release • Pitched to 50 different publications, 35 picked it up • Radio broadcast

20. Potter Model Is it ethical to over-prescribe antibiotics to children to please parents? Definition Yes – Antibiotics help children get better and decrease parental concern. No – Children should not be take an abundant number of antibiotics due to health risks. Loyalties Yes – Increase revenue – keeping the company in existence. No – Over-prescribing antibiotics to children is wrong. Values Yes – Antibiotics decrease sickness and make people feel they received accurate treatment. No – Honesty and integrity are more important than comforting parents with antibiotics. Principles Yes – Aristotle’s Golden Mean: “Greatest good for the greatest number.” Mill’s Principle of Utility: “What is useful is right” No - Rawl’s Veil of Ignorance: “Eliminate roles to justly decide.”